by Dr. Alice Brock-Utne
Ever since Coronavirus began its relentless march around the world, I’ve noticed fearful, conspiracy based, and dystopian logic creeping into my patients’ decisions about vaccination. I see healthy families electing to skip routine inoculations and other preventive care even though doing so puts their families and our communities in danger of worse health, death, disability, and tragedy. We are in the middle of a pandemic with a scientific community on overdrive to bring us a new vaccine, yet I’m watching loving parents choose to skip even the routine vaccines that have been given billions of times. The pandemic, coupled with the resulting economic upheaval and bitter political divide, has left families not knowing who to trust. So, if they’re now opting out of routine vaccines, what will they do when I can offer the COVID19 vaccine?
The COVID19 vaccine is set to break records for fastest to market. The reason won’t be shoddy science or political ploy. This fast-tracking is due to the necessity (and possibility) of ending a massive global crisis.
Like my patients, I’m not without fear. But my trepidation has nothing to do with the safety of the vaccine itself. For the first millions of doses, the greatest risk is that the vaccine won’t end our pandemic. Maybe the immunity it gives won’t last long enough to sustain herd immunity. Maybe enough of the general population will refuse to take the vaccine and not enough doses will be given to slow down the spread of the disease. Those are the things that keep me up at night, not the possible side effects of what will surely be a medical milestone.
We’ve learned more about COVID19 faster than any other new disease to ever emerge on earth. It would be incongruent if vaccine development didn’t break records. So to my patients who worry that the vaccine is being developed too fast, I say don’t.
The COVID19 vaccine is set to break records for fastest to market. The reason won’t be shoddy science or political ploy. This fast-tracking is due to the necessity (and possibility) of ending a massive global crisis. The once-in-a-lifetime chance to change for the better the life of every human on earth has scientists worldwide working overtime, collaborating in new ways, and cross-pollinating different fields with different ideas. Within weeks of word leaking out about a new respiratory disease in Wuhan, experts in genome sequencing had published the full genome of COVID19 and shared their findings with every major lab in the world. At all the world’s universities, scientists using artificial intelligence, mathematical modeling and engineering began sharing ideas and collaborating to try to understand its spread and find ways to fight it. Scientific journals previously only accessible for a fee opened up free access to their publications related to COVID19. Experts in the study of populations began publishing data about who was at most risk and labs began testing old and new drugs that were postulated to help. It was an unprecedented response to an unprecedented health emergency. Several vaccines moved rapidly into trials because they could piggyback on a decade and a half of research into COVID19’s relatives SARS and MERS, two related deadly coronaviruses that emerged in the early 2000s. We’ve learned more about COVID19 faster than any other new disease to ever emerge on earth. It would be incongruent if vaccine development didn’t break records. So to my patients who worry that the vaccine is being developed too fast, I say don’t.
.... vaccination is the greatest success story of public health in the past 100 years...
Four different coronavirus vaccines have already cleared the hurdle of phase two trials in the United States. The purpose of those trials is to demonstrate safety. Thousands of volunteers received their COVID19 vaccine in the first half of 2020. Now, in phase three trials, we are trying to prove the vaccines are effective at providing immunity. By the time I offer these vaccines in my office, tens to hundreds of thousands of doses will have been given. Once general vaccination begins, there will be millions. As with everything, the more time that passes, the more people that receive the vaccine, the more we’ll know. One day, after a billion doses of the COVID19 vaccine have been given and enough time has passed, we’ll know as much about the COVID19 vaccine as we do about old vaccines. Until then, whatever unknown one-in-a-billion risk the Coronavirus vaccine may have, there is a lot of known benefit. The vaccine is our best chance that businesses can fully re-open, our children can go back to school, and our families can gather without fear of infecting one another.
Think of those in your life whose trust you have earned. Talk to them about vaccination. Let’s make decisions together that make sense for our health and let’s do things for each other with the good of our community in mind.
But it’s not just the new Coronavirus vaccine that needs our attention. Even though vaccination is the greatest success story of public health in the past 100 years, the COVID19 pandemic is threatening that success. Vaccines are given millions of times a year, every year. In the past 10 years, more than one billion children have been vaccinated worldwide. Over the past 20 years, vaccination in the United States alone has saved 732,000 lives and prevented 21 million hospitalizations. Between 2010 and 2015, 10 million deaths worldwide were prevented by vaccination. “Boots on the ground” efforts have succeeded in increasing the rate of full vaccination against diphtheria, tetanus, and whooping cough from 20% of the world’s children in 1980 to 85% of children in 2019. But, between January 2020 to April 2020 the relative rates of vaccination have dropped on every continent on Earth, some as much as 50%! Worldwide in 2020, we’ve seen the highest number of cases of measles - a disease once thought controlled - in decades. Even in the United States, where vaccination is routinely recommended and access to vaccines is nearly universal, doctor’s offices have been strained by lack of protective equipment for workers and access to doctor offices has been diminished. But the insidious danger I see in my office every day, the one that can’t be solved through ingenuity, logistical redesign of healthcare delivery, and masks, is the danger that patients don’t trust decades of research, the mandatory reporting of side effects, or their doctor — and stop vaccinating their children by choice.
Only together can we pull our communities out of this pandemic.
I try to earn the trust of my patients by listening to them, being honest with them, and by carefully informing them about how to keep their families safe. Think of those in your life whose trust you have earned. Talk to them about vaccination. Let’s make decisions together that make sense for our health and let’s do things for each other with the good of our community in mind. Even in dystopian 2020, I still believe we make our world a better place through community. Getting your family vaccinated is your most community-oriented medical decision, and you get to benefit from it,too! Take your routine vaccinations and when the Coronavirus vaccine becomes available, take it, as well. Only together can we pull our communities out of this pandemic.
Alice Brock-Utne, MD is a pediatrician and mother of three with a streak of geek for science.